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An ideology of uncertainty reduction pervades scholarly and popular discourse on breast self-exams (BSE). Women are encouraged to understand BSE as an activity that reduces uncertainty about their health. Moreover, uncertainties about the procedure itself are conceived as barriers to BSE. In turn, reducing these uncertainties is seen as the key to promoting BSE. We argue that the ideology of uncertainty reduction is both descriptively and prescriptively inadequate and potentially a threat to women’s health. We further contend the ideology should be replaced by a framework that illuminates processes of coping with uncertainty. Several major characteristics of such a framework, as well as implications for medical practice, are discussed and illustrated within the context of BSE.